RESUMEN
BACKGROUND: Urinary tract infection (UTI) is common among children. Empiric antibiotics have to be started as early as possible or it may lead to an irreversible renal parenchymal damage and renal scarring in children. The objectives were to determine the prevalence and microbial profile of paediatric UTI and to determine the antimicrobial susceptibility pattern. METHODOLOGY: This is a retrospective study which looked at urine cultures of children below 15 years that were sent during the study period. RESULTS: Among the total urine cultures sent only 21.2% showed significant growth of organisms. The most common organism isolated was E. coli (75.5%). E. coli was least sensitive to cefpodoxime and co-trimoxazole, whereas highly sensitive to nitrofurantoin. Of the total children who had significant growth, 46% had ESBL. DISCUSSION: The prevalence of culture-proven UTI among children was found to be 21.2%. The most common organism isolated among the study population was E. coli (75.5%) followed by Enterococcus species (19.0%) and Klebsiella species (14.5%). It was also found that E. coli was least sensitive to cefpodoxime (31.6%) and co-trimoxazole (26.3%), moderately to amoxicillin-clavulanate (52.4%), whereas highly sensitive to nitrofurantoin (82.9%). This was similar with the studies done at other secondary care hospitals, in Oman and Oddanchathram, South India. CONCLUSIONS: With the increasing resistance, cephalosporins should not be used in treating paediatric UTI, whereas nitrofurantoin can be started as an empiric antibiotic, which can later be changed according to the susceptibility pattern.
RESUMEN
BACKGROUND: World-wide, drowning is one of the leading causes of death in children between 1 and 12 years of age, especially in low- and middle-income countries. AIM: To assess the community's perceptions of the common causes of death in children, the level of awareness of drowning as a major cause and the reasons for the high rate of drowning, and to discuss preventive measures. METHOD: Five focus group discussions were conducted with representatives from five different categories of people in the community. The groups included health aides, extension workers and part-time community health workers in the peripheral health care team of the Department of Community Health, Christian Medical College, Vellore and land owners/village leaders. The data were analysed using content analysis to detect themes and trends. RESULTS: Drowning was not perceived as a major cause of childhood death. Unprotected bodies of water was acknowledged as a reason for the high rate of drowning. The groups suggested some preventive measures including intensive education on the causes of drowning, the introduction of more balwadis (day nurseries) in the villages, and the identification of resources to protect open bodies of water. CONCLUSIONS: There is an urgent need among rural communities to create awareness of the high rate of drowning in children and to motivate and facilitate individuals, communities, organisations and government agencies to make the communities safer for children.
